HIV pre-exposure prophylaxis for people who inject drugs: a review of current results and an agenda for future research
Daniel J Escudero, Mark N Lurie, Thomas Kerr, Chanelle J Howe, Brandon D L Marshall
Introduction: Studies examining the use of pre-exposure prophylaxis (PrEP) to prevent HIV transmission among people who
inject drugs (PWIDs) have not been adequately summarized. Recently, the Bangkok Tenofovir Study has shown that PrEP may be effective at
reducing new HIV infections among this high-risk group. This randomized controlled trial was the first study to specifically examine
the efficacy of PrEP among PWIDs. In this review, we present the current state of evidence regarding the use of PrEP to prevent
HIV infection in PWID populations, and set an agenda for future research to inform the most effective implementation of PrEP
in the context of existing evidence-based HIV prevention strategies.
Discussion: Despite positive trial results confirming that PrEP may prevent HIV transmission among PWIDs, there remain
many questions regarding the interpretation of these results, as well as obstacles to the implementation of PrEP regimens within highly
diverse drug-using communities. Aside from the Bangkok Tenofovir Study, we identified only one other published study that has
collected empirical data to inform the use of PrEP among PWIDs. The large gap in research regarding the use and
implementation of PrEP for PWIDs signals the need for further research and attention.
Conclusions: We recommend that future research efforts focus on elucidating the generalizability of the Bangkok Tenofovir
Study results in other injection drug-using populations, examining the willingness of PWIDs to use PrEP in diverse contexts, identifying
barriers to adherence to PrEP regimens and determining the most effective ways to implement PrEP programmes within the context of
existing evidence-based prevention strategies, including opioid substitution therapy and needle and syringe distribution programmes.
Keywords: HIV; pre-exposure prophylaxis; injection drug use; people who inject drugs.
(Published: 27 March 2014)
Citation: Escudero DJ et al. Journal of the International AIDS Society 2014, 17 :18899
http://www.jiasociety.org/index.php/jias/article/view/18899 | http://dx.doi.org/10.7448/IAS.17.1.18899
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Journal of the International AIDS Society | eISSN 1758-2652 | Editors-in-Chief: Mark Wainberg, Susan Kippax and Papa Salif Sow
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